Healthcare Careers

Quality Improvement Nurse (Managed Care)

California, California | Permanent

THE HEALTHCARE INITIATIVE

Where Talent Meets Opportunity

 

Quality Improvement Nurse (Managed Care)

California

 

Position:

A progressive and growing Healthcare organization looking for a Nurse Manager: Quality improvement to perform activities related to HEDIS (Healthcare Effectiveness and Data Information Set), facility site review, and complaint/grievance resolution. In addition, this position is responsible for planning, implementing, and monitoring quality improvement activities to ensure members receive quality care in compliance with organizational, regulatory, and contractual requirements. Work is semi-routine and occasionally varied and moderately complex and requires a limited to moderate degree of discretion and independent judgment. This position works closely with and reports to the

 

Position Type/Expected schedule:

  • Hybrid work environment: Remote/ office /site reviews at healthcare facilities.
  • Monday-Friday work schedule

 

Qualifications:

  • Bachelor’s degree in nursing, required
  • Unrestricted California Registered Nurse license, required
  • 5+ years clinical experience as a nurse in an acute care setting, required
  • 3+ years of recent experience working in Quality improvement in a Healthcare setting, preferred.
  • Recent experience working in a managed care setting, preferred
  • Experience working with Medi-Cal and/or Medicare populations, strongly preferred
  • Valid California driver license and reliable transportation required

 

Key Skill Set:

  • Organized
  • Time Management
  • Effective communication skills both written and verbal
  • Discreet/confidential
  • Detail Oriented
  • Analytical

 

Location:

This location offers many outdoors areas to explore and enjoy while being centrally located to re-known universities, a wide variety of sporting events, a variety of museums and some of the best dining in the United States.

 

We look forward to an opportunity to speak to you. To apply or schedule a confidential phone conversation, please send your resume (MS WORD format preferred) to

alison@thi-search.com or call 720-735-9739

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